Strategies to improve diversity, equity, and inclusion in clinical trials

Abstract

There is a growing need for diversity, equity, and inclusion (DEI) in cancer care, particularly with respect to equal access and accrual to clinical trials. This commentary describe steps taken to address disparities in the authors' own clinical practice and proposes actions at the patient, provider, community, and institution levels to improve DEI in clinical trials.

Keywords: cancer; clinical trials; diversity; equity; inclusion.

Figure 1

Patients interact with their families and carry a set of health beliefs that are informed by culture, background, and prior experiences in medicine (A). Providers work within a health care system that may have limited capacity to support clinical research, and even less capacity to support enrollment of diverse patients onto trials (B). Both patients and providers exist as part of a larger community and society and the norms, beliefs, and attitudes that exist through multiple levels collectively influence how patients and providers communicate about cancer therapy and clinical trials (C). Adapted with permission from Paskett et al.

Figure 2

Multilevel interventions to address barriers and improve clinical trial access and enrollment. (A) Collecting sociodemographic data and patient‐reported social determinants of health. (B) Bolstering the research infrastructure, expanding access to interpreter services, and addressing logistical barriers in low‐resource settings. (C) Understanding how health beliefs, patient comprehension, communication, and perceptions of clinical research influence clinical trial enrollment decisions among diverse populations. At the community level, policy changes and interventions aimed at confronting systemic racism and its numerous sequelae are critical.